ES2339611T3 - BLOOD TREATMENT DEVICE AND PROCEDURE FOR EMPTYING A SET OF FLEXIBLE PIPES FOR BLOODING A BLOOD TREATMENT APPARATUS. - Google Patents

Abstract

A method for emptying a blood tubing set of a blood treatment device that includes an extracorporeal blood circuit with a membrane filter includes supplying air or gas to the blood tubing set to displace liquid therein. The blood tubing set includes arterial and venous patient blood tubes in communication with a first chamber of the membrane filter. The device also includes a substituate line which opens into the arterial blood tube and/or into the venous blood tube, and a substituate pump. To empty the blood tubing set, the arterial blood tube and the venous blood tube are connected to one another to provide a circuit that includes the membrane filter, the arterial blood tube, and the venous blood tube. The substituate line is disconnected, and the air or gas is pumped into the blood tubing set so as to displace liquid into a second chamber of the membrane filter.

Description

Apparatus for the treatment of blood and procedure to empty a set of flexible tubes for blood  of a device for the treatment of blood.

The invention relates to a method for empty a set of flexible tubes for blood from an apparatus for the treatment of blood in order to carry out a extracorporeal blood treatment with a membrane filter, which presents a first camera, specifically a camera for blood, and a second chamber that is separated from the previous one by middle of a membrane, the first chamber being traversed by the blood during operation of the device for the treatment of the blood and the second chamber is traversed by the filtrate during the operation of the blood treatment apparatus, and covering the flexible tube set for blood a flexible tube for arterial blood and a flexible tube for venous blood, being in communication both with the first membrane filter chamber and leading the patient's blood to the membrane filter and, from the membrane filter, to the patient, during operation of the device for the treatment of blood as well as with a conduit for the substitute, which flows into a tube flexible for arterial blood and / or in a flexible blood tube venous and with a pump for the substitute, which is found in communication with the duct for the substitute in such a way that transports substitute from a substitute source through the duct for substitute. The membrane filter, which has been cited, is constituted for example by a filter for hemodialysis or is constituted by a hemofilter.

Various prior art are known from the state of the art procedures for emptying a set of tubes Flexible for blood. It is known by EP 1 161 271 A1 carry out the operation of the dialysate pumps, which found on the side of the dialysate, in order to carry out the emptying the hose set for blood in such a way that a fall of the dialyzer is regulated pressure, by means of which the liquid is transported, which found in the set of flexible tubes for blood, through the dialyzer membrane on the dialysate side, that is to the second chamber and from there it is removed by means of evacuation ducts. With the set of flexible tubes for blood is in communication a bag of substitute, which crushes as a result of emptying the hose set for the blood or respectively due to the low pressure that It is in them. As soon as the pressure has dropped below a certain threshold value in the game of flexible tubes for blood, a valve is opened, through which sucks air in the hose set for the blood until the pressure, which is in the tube set flexible for blood, correspond to atmospheric pressure.

During the emptying of the hose set for blood through the dialyzer membrane is found running the blood pump until it has been removed the liquid from the hose set for the blood.

It is known by EP 0 830 153 A1 move, by air, the liquid from the tube set flexible for blood as well as from the circuit of the dialysate, as a previous step to the corresponding Flexible pipe ducts are removed from the dialyzer.

Publication DE 34 42 744 A1 discloses, by last, a procedure, according to which the liquid moves, which It is in the set of flexible tubes for blood, with support of an annular conduit in the set of flexible tubes for the blood and through an air source. The purpose of the request patent is to be able to carry out a verification of the leaks or a pressure resistance in the dialyzer.

The present invention has the task of withdrawing of the set of flexible tubes for blood, in a simple way and efficient, the mixture consisting of blood and agent displacement or substitute that remains once after the restitution of the blood in the patient or that is left after the treatment of blood in the set of flexible tubes for blood.

This task is solved by means of a procedure with the features of claim 1. Of In accordance with this procedure, the tube is intended flexible for arterial blood and that the flexible tube for venous blood are connected to each other, in order to carry out emptying the set of flexible tubes for blood, such so that a circuit is established that encompasses the camera for the blood, the flexible tube for arterial blood and the flexible tube for venous blood, disconnecting the substitute duct of the substitute source and pumping air into the tube set flexible for the blood by means of the pump for the substitute, in such a way that an overpressure is established in the set of flexible tubes for blood, by means of which it is displaced the liquid from the chamber for blood through the membrane to the second chamber of the membrane filter.

Accordingly, the object of the invention is to take advantage of the pump for the substitute, which is present anyway, to transport air to the set of flexible tubes for blood in order to carry out the emptying of the blood hose, after which it it displaces the mixture formed by blood and by substitute or by agent displacement through the membrane of the chamber to blood to the second membrane filter chamber and from This chamber is discharged through evacuation ducts. From In this way, it is possible to carry out an efficient displacement of the liquid from the set of flexible tubes for blood with a comparatively small cost.

The procedure, in accordance with the invention, takes place without patient participation, that is a Once the treatment of the patient is finished, when the patients

As soon as the procedure is finished for emptying, according to the invention, it can be removed the set of flexible tubes for blood, which is usually consisting of a single use item (disposable -available-). By emptying the hose set blood removal costs can be reduced waste as a result of the lower mass of waste. By On the other hand, hygienic reasons make a complete emptying necessary of the set of flexible tubes for blood as a previous step to the Waste disposal

To carry out the procedure of in accordance with the invention, the apparatus for the treatment of Blood presents a pilot. In this case it may be a additional control apparatus for the control apparatus, which is present anyway, of the apparatus for the treatment of blood. You can also imagine that all the piloting cited is made in the control apparatus, which is present of all modes, for the operation of the apparatus for the treatment of blood, expanding this control device, in this case, of preferably so as to carry out the activation of the pump for the substitute and / or the pressure sensor and / or the possible valves in the blood hose or in arterial or venous branching and / or possible automatically the air inlet in the duct for the substitute for the set of flexible tubes for blood. These extensions can be carried out, for example, by means of a modification of the computer program.

In this context it should be noted that the duct disconnection for source substitute Substitute is preferably carried out manually by the personnel that carries out the treatment. Without However, you can also imagine the automation of an opening facing the surrounding environment and carrying it out of piloting. Under the concept of "disconnection" should be understood within the scope of the present invention, not only the separation body, that is the disconnection of the duct for the substitute of the substitute source but also, for example, the duct sealing between the pump for the substitute and the substitute source.

In another configuration of the invention, The substitute pump is intended to be air driven of the surrounding environment, which is then transported through from the pump for the substitute to the hose set for the blood

The duct for the substitute may be performed as a conduit for predilution and / or as a conduit for post dilution Such ducts are used to carry out the dilution of blood as a step prior to entering the chamber for blood (predilution) or after departure from chamber for blood (post-dilution), during the operation of the apparatus for the treatment of blood. It can also imagine a combined way of proceeding of predilution and of post dilution

The duct for the substitute may be branched in this embodiment of the invention, in a conduit for pre-dilution and in a conduit for post-dilution which, on the one hand, flows in front of the membrane filter in the flexible tube for arterial blood and that, on the other hand, flows behind the membrane filter in the flexible tube for venous blood.

Preferably, it is expected to be blocked one of the two ducts (predilution duct, post-dilution duct) during emptying of the tube set flexible for blood in such a way that it is only transported through the other conduit to the tube set flexible for blood the compressed air in the pump for the substitute

For example, you can imagine that both the conduit for predilution as well as the post-dilution conduit are equipped with blocking valves, by means of which the ducts can be blocked. From Example way, you can imagine that the duct valve for pre-dilution it is closed and that, thus, only be transported through the conduit for post-dilution until the set of flexible tubes for blood compressed air by Pump medium for substitute.

In another configuration of the invention, provided that a blood pump is arranged in such a way that is in communication with a flexible tube for blood, preferably with the blood hose arterial so that blood is transported through the set of flexible tubes for blood during operation of the blood treatment apparatus, being in operation, at least temporarily, the blood pump during the emptying of the set of flexible tubes for blood. The blood pump can act accordingly to favor the emptying of the hose set for blood.

In another configuration of the invention, provided that the air is transported, which is transported by pump medium for the substitute, through the conduit for the predilution or through the conduit for post-dilution until flexible tube for arterial blood or even the flexible tube for venous blood and distributed in it in such a way that the air or that the liquid displaced by the air penetrates the chamber for blood both through the flexible tube for the arterial blood as well as through the flexible tube to venous blood For example, it is possible that the air be introduced into the flexible tube for venous blood through of the conduit for post-dilution and that is subdivided into it. A part of the air arrives in the opposite direction to the direction of flow usual in the operation of the apparatus for the treatment of blood, on the one hand to the chamber for blood and the other part of the air arrives, passing through the bridge, which is located between the flexible tube for arterial blood and flexible tube for venous blood, through the arterial duct, on the other side to the chamber for blood. In this way, it is possible to complete emptying of the hose set for blood with comparatively simple means.

In accordance with other configuration of the invention may be provided that the pump for the substitute is disconnected again after a predetermined period of time from the moment of connection. Therefore it is possible stop the pump for the substitute after a period of time defined and the set of flexible tubes can be considered for The blood has been emptied.

Similarly, you can imagine that it is provided a pressure sensor that is arranged in such a way measure the pressure in the flexible tube for arterial blood and / or in the flexible tube for venous blood and that a control equipment with which the pressure sensor is connected and disconnect the pump for the substitute as soon as the pressure, detected by means of the pressure sensor, exceeds a threshold value A wet membrane is essentially more permeable for the liquid that stops the air and therefore can be measured a significant increase in pressure at the moment when produce the complete emptying, whose increase in pressure is used in this embodiment of the invention to disconnect the pump for the substitute, since the set of Flexible tubes for blood is identified as empty.

In another configuration of the invention it is possible a segment of the duct branch from the flexible tube for arterial blood and / or from the flexible blood tube venous and that this segment of the duct is connected to the tube flexible for arterial blood or with the flexible tube for venous blood or with another segment of the duct assigned to it to establish the circuit In this case it has been planned as well same, as the flexible tube for arterial blood and / or the tube flexible for venous blood is blocked downstream of the mouthpiece of the branching duct segment in order to prevent liquid from flowing out of the blood hose arterial or from the flexible tube for venous blood.

The invention also relates to a device for the treatment of blood with an extracorporeal blood circuit, which is suitable for housing a set of flexible tubes for blood as well as a membrane filter with a first chamber and with a second chamber, separated from the previous one by means of a membrane, the first chamber being traversed by blood during operation of the blood treatment apparatus and the second chamber being traversed by filtration during operation of the device for the treatment of blood. The blood treatment apparatus is characterized in that it has a pump for the substitute as well as a control unit, which activates the pump for the substitute, in order to carry out the emptying of the set of flexible tubes for the blood of such that air or gas is pumped in the set of flexible tubes for blood by means of the pump for the substitute in such a way that an overpressure is established in the set of flexible tubes for blood, by means of whose overpressure the liquid is displaced through the membrane filter membrane from the first chamber to the second membrane filter chamber.

In the preferred configuration of the invention the pump for the substitute is intended to be made of such that it breathes air from the surrounding environment once it has been made duct disconnection for substitute and transport to the set of flexible tubes for blood.

In another configuration of the invention, planned a blood pump that is powered by the control unit, in order to carry out the emptying of the game of flexible tubes for blood, such that during emptying of the hose set for blood is in functioning permanently or temporarily.

In another configuration of the invention, the unit control has been carried out in such a way that it disconnects again to the pump for the substitute after a period of time Default from the moment of connection. In this way, it presents the possibility that the control unit stops the pump for the substitute after a period of time defined and that the set of flexible tubes for blood be then considered as empty.

In another configuration of the invention, provided a pressure sensor, which is connected to the unit of control and that is arranged in such a way that it measures the pressure in the flexible tube for arterial blood and / or the flexible tube for venous blood. In this case, it is planned that the pump for the substitute be disconnected by the control team so soon as the pressure, detected by means of the sensor of the pressure, exceed a threshold value.

Other details and advantages of the invention are explain in greater detail by means of an embodiment represented in the drawing. The unique figure shows a schematic representation of a procedure for treatment of blood, taking as an example a procedure of hemodiafiltration

The device for the treatment of blood It presents a side for filtering and an extracorporeal circuit for the blood. The extracorporeal blood circuit encompasses a game of flexible tubes for blood as well as a first chamber 20 of the membrane filter 10, which is separated from the second chamber 30 by means of a semipermeable membrane. During operation blood is drawn from the device through the tube flexible 60 for arterial blood, is introduced in the first chamber 20 and conducts back to the patient through the tube flexible 70 for venous blood as well as through the chamber of Drip 72, found in it. Blood transport in the extracorporeal circuit is carried out through the pump for blood 80, which is arranged in flexible tube 60 for arterial blood The dashed line characterizes in the the part of the provision that has been made as disposable.

As highlighted in the figure, it has been planned a pump 50 for the substitute, which is located in the conduit 40 for the substitute. The duct for the substitute presents a connection, through which the conduit 40 for the substitute with a source of substitute. He substitute undergoes online treatment in this example of realization in the apparatus for the treatment of blood and is supplied in port 41 for the substitute. Can basically imagine also that a substitute source is planned independent of the machine for the treatment of blood.

During operation, pump 50 stops the substitute transports the substitute through conduit 40 to the substitute The duct 40 for the substitute flows into the flexible tube set for blood through a conduit for predilution 42 and through a conduit for post-dilution 44. In particular, it is provided that the conduit for predilution 42 drain into flexible tube 60 for arterial blood and that the post-dilution conduit 44 drain into flexible tube 70 for venous blood. As can be seen through the figure, the conduit for predilution 42 flows into a segment of the conduit between the blood pump 80 and the first membrane filter chamber 10. The conduit for post-dilution 44 flows into a segment of the duct between the filter of membrane 10 and the drip chamber 72 venous.

In order to carry out the emptying of the game of flexible tubes for blood covering flexible tubes 60 and 70, the duct 40 for the substitute is now separated, preferably manually, by the staff that leads to out the treatment, of the port 41 connecting the source of the substitute On the other hand, segment 110 of the duct, which branches off the flexible tube 60 for blood arterial, by means of connectors 111, 112, with flexible tube 70 for venous blood likewise preferably so manual by the personnel that carries out the treatment of such so, that a circuit is established covering flexible tube 60 for arterial blood, to flexible tube 70 for venous blood, to the venous drip chamber 72 and to the first chamber 20 of the filter of membrane 10. The segment of the flexible tube 60 for blood arterial, which does not belong to this circuit, which is found by below the outlet point of the branch duct 110, it is sealed by means of a blocking element 140.

Pump for substitute 50 transports now air, according to the disconnection of the duct for the substitute source substitute, up to conduit 40 for the substitute as characterized by means of the arrow and of the reference "m + n". Meanwhile the conduit for predilution 42 is closed by means of a suitable valve. By consequently, all the air flow, which is transported to through pump 50 for the substitute, it is transported through from conduit for post-dilution 44 to flexible tube 70 for venous blood This stream is subdivided here in the streams partial "n" and "m", penetrating the partial current "n" or the liquid, which is displaced by it, in the first chamber 20 of the membrane filter 10 in the opposite direction to the usual flow direction during operation of the apparatus for the treatment of blood, in accordance with the figure, from up through the outlet pipe. The other part of the air supplied, which has been characterized in the figure with the reference "m", or the liquid, which is displaced by means of the it is conducted through a venous drip chamber 72 and reaches the flexible tube 60 for arterial blood through connectors 111, 112 and segment 110 of the conduit and, through of this one passing through the power port of the first chamber, to the first chamber 20 of the membrane filter 10.

The first chamber 20 of the membrane filter 10 it is therefore driven on both sides with air / liquid and, therefore, with pressure in such a way, that the liquid or the liquid / air mixture, found in the tube set flexible for blood, it is transported from the first chamber 20 through the semipermeable membrane to the second chamber 30 of membrane filter 10 and then discharged by means of the duct 120.

During this emptying process it can work permanently or at least temporarily pump 80 to the blood, which is in the flexible tube 60 for the blood arterial, to favor the emptying process. Waters below the pump 80 for blood is located in flexible tube 60 for arterial blood pressure sensor 100, which measures the pressure in flexible tube 60 for arterial blood during the process of emptying When the measured pressure value drops below of a threshold value, it will be established that the set of flexible tubes for blood and the pumps 50 will be disconnected, 80.

Alternatively, there is the possibility of conclude the emptying process after a period of time determined from the beginning of the process.

The process according to the invention offers a simple and efficient possibility to carry out the emptying a set of flexible tubes for blood, by means of which reduces the weight of the waste and improves hygiene. He procedure, in accordance with the invention, is developed preferably automatically, that is, preferred, no intervention is required by the user, with the exception of the disconnection of the conduit for the substitute of the connecting port of the substitute and the momentary shutter of the connectors 111, 112 (which is preferably carried out manually).

Claims (14)

1. Procedure for carrying out the emptying of a set of flexible tubes for the blood of an apparatus for the treatment of blood with extracorporeal blood circuit with a membrane filter (10), which has a first chamber (20) and a second chamber (30), which is separated from the previous one by means of a membrane, the first chamber (20) being flown through the blood during operation of the blood treatment apparatus and the second one being run through the filtrate chamber (30) during operation of the apparatus for the treatment of blood, and comprising the set of flexible tubes for blood a flexible tube (60) for arterial blood and a flexible tube (70) for venous blood, being connected both with the first chamber (20) of the membrane filter (10) and which carry blood from the patient to the membrane filter (10) and from the membrane filter (10) to the patient during operation of the apparatus for the tra treatment of the blood, as well as with a conduit (40) for the substitute, which flows into the flexible tube (60) for arterial blood and / or the flexible blood tube (70) for venous blood, and a pump (50) for the substitute, which is connected to the conduit (40) for the substitute in such a way, that it transports the substitute from a substitute source through the conduit (40) for the substitute (40), characterized in that they are connected to each other the flexible tube (60) for arterial blood and the flexible tube (70) for venous blood, in order to carry out the emptying of the set of flexible tubes for blood in such a way, that a circuit is formed covering the membrane filter (10), the flexible tube (60) for arterial blood and the flexible tube (70) for venous blood, because the duct (40) for the substitute is disconnected from the source of the substitute and because air or gas is pumped into the set of flexible tubes for blood per m The pump (50) for the substitute is such that an overpressure is established in the set of flexible tubes for the blood, by means of whose overpressure the liquid is displaced through the membrane of the membrane filter (10) to the second chamber (30) of the membrane filter (10). Method according to claim 1, characterized in that the pump (50) for the substitute is driven with air from the surrounding medium, which is transported in the set of flexible tubes for blood by means of the pump (50) for the substitute. Method according to claim 1 or 2, characterized in that the conduit (40) for the substitute is made in the form of a conduit for pre-dilution (42) and / or in the form of a conduit for post-dilution (44). Method according to one of the preceding claims, characterized in that the conduit (40) for the substitute is branched in a conduit for pre-dilution (42) and in a conduit for post-dilution (44) and because during the emptying of the tube set Flexible for blood, the pre-dilution duct (42) or the post-dilution duct (44) is blocked in such a way that the air, which is compressed in the pump (50) for the substitute, is transported only through the pre-dilution duct (42) or through the post-dilution duct (44) to the set of flexible blood tubes. Method according to one of the preceding claims, characterized in that a blood pump (80) has been arranged, which is connected to one of the flexible blood tubes, preferably with the flexible tube (60) for arterial blood of such that blood is transported through the set of flexible blood tubes during the operation of the blood treatment apparatus and because the blood pump (80) is in permanent or temporary operation during the emptying of the game of flexible tubes for
blood. Method according to one of the preceding claims, characterized in that the air, which is transported by means of the pump (50) for the substitute, is transported through the pre-dilution duct (42) or through the post-dilution duct ( 44) to the flexible tube (60) for arterial blood or to the flexible tube (70) for venous blood and is subdivided into this flexible tube in such a way that the air or the liquid, displaced by the air, it penetrates the first chamber (20) of the membrane filter (10) through the flexible tube (60) for arterial blood as well as through the flexible tube (70) for venous blood. Method according to one of the preceding claims, characterized in that the pump (50) for the substitute is switched off again after a predetermined period of time, from the moment of connection. Method according to one of claims 1 to 6, characterized in that a pressure sensor (100) is provided, which is arranged in such a way that it measures the pressure in the flexible tube (60) for arterial blood and / or in the flexible tube (70) for venous blood and because a control device is provided, with which the pressure sensor (100) has been connected and which disconnects the pump (50) for the substitute as soon as the pressure, detected by means of the pressure sensor (100), exceeds a threshold value. Method according to one of the preceding claims, characterized in that a segment (110) of the duct is branched from the flexible tube (60) for arterial blood and / or from the flexible tube (70) for venous blood, because this segment (110) duct is connected with the flexible tube (60) for arterial blood or with the flexible tube (70) for venous blood or with a section of the duct, arranged therein, and because the flexible tube (60) for arterial blood and / or the flexible tube (70) for venous blood is blocked downstream of the mouth of segment (110) of the branching duct. 10. Device for the treatment of blood with an extracorporeal circuit, which is suitable for housing a set of flexible tubes for blood as well as a membrane filter with a first chamber (20) and a second chamber (30) , which is separated from the previous one by means of a membrane, the first chamber being flown through the blood during operation of the blood treatment apparatus and the second chamber (30) being run through the filtrate during operation of the apparatus for the blood treatment, characterized in that the blood treatment apparatus has a pump (50) for the substitute and a control unit, which activates the pump (50) for the substitute, in order to carry out the emptying of the set of flexible tubes for blood, such that air or gas is pumped into the set of flexible tubes for blood by means of the pump (50) for the substitute in such a way, that a so brepression in the set of flexible tubes for blood, by means of whose overpressure the liquid is displaced through the membrane of the membrane filter (10) from the first chamber (20) to the second chamber (30) of the membrane filter (10) 11. Apparatus for the treatment of blood according to claim 10, characterized in that the pump (50) for the substitute is made in such a way that, after disconnection of the conduit (40) for the substitute of the substitute source, it sucks air of the surrounding medium through the conduit (40) for the substitute and transports it to the set of flexible tubes for blood. 12. Device according to claim 10 or 11, characterized in that a pump (80) for the blood is provided and that the control unit is realized in such a way that it activates the pump (80) for the blood, in order to carry out the emptying of the set of flexible tubes for blood, in such a way that the pump (80) for the blood works permanently or temporarily during the emptying of the set of flexible tubes for the blood. 13. Device for the treatment of blood according to one of claims 10 to 12, characterized in that the control unit is realized in such a way that the pump (50) for the substitute is switched off again after a period of time default, from the moment of connection. 14. Apparatus for the treatment of blood according to one of claims 10 to 13, characterized in that a pressure sensor (100) is provided, which is connected to the control unit and is arranged in such a way as to measure the pressure in the flexible tube (60) for arterial blood and / or in the flexible tube (70) for venous blood, and because the control unit is realized in such a way that it disconnects the pump (50) for the substitute as soon as the pressure, detected by means of the pressure sensor (100), exceeds a threshold value.